Skill 5-6: Administering an Intradermal Injection

The nurse is preparing supplies for a tuberculosis screening. The nurse should choose syringe and needle? 10-mL syringe; 3-inch, 18-gauge needle 1-mL syringe; 1/2-inch, 27-gauge needle 5-mL syringe; 2-inch, 20-gauge needle Insulin syringe; 1-inch, 16-gauge needle

1-mL syringe; 1/2-inch, 27-gauge needle Rationale:Tuberculosis screening requires an intradermal injection. Equipment used for an intradermal injection includes a tuberculin syringe calibrated in tenths and hundredths of a milliliter and a 1/4- to 1/2-inch, 25- or 27-gauge needle. The dosage given intradermally is small, usually less than 0.5 mL.

The nurse is administering an intradermal injection to a client to test for allergies. How far would the nurse insert the needle into the dermis? 1/4 in (64 mm) with half of the bevel under the skin. 1/8 in (32 mm) with half of the bevel under the skin. 1/4 in (64 mm) with the entire bevel under the skin. 1/8 in (32 mm) with the entire bevel under the skin.

1/8 in (32 mm) with the entire bevel under the skin. Rationale:The nurse would insert the needle about 1/8 in (32 mm) with the entire bevel under the skin. The dermis is entered when the needle is held as nearly parallel to the skin as possible and inserted about 1/8 in (32 mm).

Which client would most likely be injected using an intradermal injection? A client having an allergy test performed. A client receiving morphine for pain. A client being administered insulin. A client receiving a vaccination.

A client having an allergy test performed. Rationale:Intradermal injections have the longest absorption time of all parenteral routes. For this reason, intradermal injections are used for sensitivity tests, such as tuberculin and allergy tests, and local anesthesia. The body's reaction to substances is easily visible and degrees of reaction are discernible by comparative study. Insulin and morphine would most likely be administered subcutaneously or as an IV. Vaccinations are usually administered intramuscularly.

After preparing the skin of a client's arm in preparation for an intradermal injection, how would the nurse insert the needle? At a 30-degree angle, almost against the skin, bevel side up. At a 5- to 15-degree angle, almost against the skin, bevel side down. At a 5- to 15-degree angle, almost against the skin, bevel side up. At a 30-degree angle, almost against the skin, bevel side down.

At a 5- to 15-degree angle, almost against the skin, bevel side up. Rationale:The nurse would hold the needle with the dominant hand at a 5- to 15-degree angle, almost against the skin, with the bevel side up. Having the bevel side up allows for the smooth piercing of the skin and introduction of medication into the dermis. The dermis is entered when the needle is held as nearly parallel to the skin as possible.

The nurse is cleaning the injection site prior to administering an intradermal injection. What motion should the nurse use for this action? Circular motion from the outside to the injection site. Back and forth motion from the injection site outward. Back and forth motion from the outside to the injection site. Circular motion from the injection site outward.

Circular motion from the injection site outward. Rationale:The nurse would clean the injection site with an antimicrobial swab in a circular motion from the injection site outward and allow it to dry. Pathogens on the skin can be forced into the tissues by the needle. Moving from the center outward prevents contamination of the site.

The nurse is preparing a local anesthetic to be administered intradermally to a client undergoing a minor surgical procedure. Which guideline is recommended for administering this injection? Recap the needle following administration. Clean the site with soap and water prior to administration. Do not massage the site following administration. Apply gentle pressure to the site with a gauze pad following administration.

Do not massage the site following administration. Rationale:Following an injection, the site should not be massaged, nor should pressure be applied. The nurse would clean the injection site with an antimicrobial swab. Used needles should not be recapped.

The nurse is preparing to administer an allergy test via an intradermal injection. Which injection site would be most appropriate in this situation? Shoulder Inner surface of the forearm Abdomen Anterior aspect of the thigh

Inner surface of the forearm Rationale:Sites commonly used for intradermal injections are the inner surface of the forearm and the upper back, under the scapula. The deltoid muscle of the shoulder is a common injection site for intramuscular injections. The abdomen and anterior aspect of the thigh are common injection sites for subcutaneous injections.

The nurse has a prescription to administer a tuberculin test for a client. On what body site would the injection be administered? Thigh. Deltoid muscle. Inner surface of the forearm. Abdomen.

Inner surface of the forearm. Rationale:Common sites to administer intradermal injections are the inner surface of the forearm or the upper back, under the scapula. The deltoid muscle is used for intramuscular injections, and the abdomen and thigh are used for subcutaneous injections.

A nurse is giving a client an intradermal injection to perform a tuberculin test. In what layer of the skin are intradermal injections administered? Just above the subcutaneous tissue. Just below the dermis. Just above the epidermis. Just below the epidermis.

Just below the epidermis. Rationale:Intradermal injections are administered into the dermis, just below the epidermis. The epidermis is the first layer of the skin, the dermis is the second layer, and the subcutaneous tissue is the third layer.

When administering an intradermal injection, what sign will the nurse observe that indicates when to pull out the needle? Puckering Wheal Blood Bruising

Wheal Rationale:The nurse would pull the needle out quickly at the same angle it was inserted when a small blister or wheal appears. This minimizes tissue damage and discomfort for the client.